For people who have schizophrenia, and don't get treatment, the result
is far too often that they end up homeless or in jail (most often due
to minor offenses).

Approximately 200,000 individuals with schizophrenia or manic-depressive
(bipolar disorder) illness are homeless, constituting one-third of the
approximately 600,000 homeless population (total homeless population
statistic based on data from Department of Health and Human Services).
These 200,000 individuals comprise more than the entire population of
many U.S. cities, such as Hartford, Connecticut; Charleston, South Carolina;
Reno, Nevada; Boise, Idaho; Scottsdale, Arizona; Orlando, Florida; Winston
Salem, North Carolina; Ann Arbor, Michigan; Abilene, Texas or Topeka,
Kansas.

At any given time, there are more people with untreated severe psychiatric
illnesses living on Americas streets than are receiving care in
hospitals. Approximately 90,000 individuals with schizophrenia or manic-depressive
illness are in hospitals receiving treatment for their disease.
Source: Treatment
Advocacy Center

Schizophrenia and Violence

People with schizophrenia are far more likely to harm themselves than
be violent toward the public. Violence is not a symptom of schizophrenia.

News and entertainment media tend to link mental illnesses including
schizophrenia to criminal violence. Most people with schizophrenia, however,
are not violent toward others but are withdrawn and prefer to be left
alone. Drug or alcohol abuse raises the risk of violence in people with
schizophrenia, particularly if the illness is untreated, but also in people
who have no mental illness. When violence does occur, it is most frequently
targeted at family members and friends, and more often takes place at
home.

Substance abuse (i.e. street drugs and alcohol) significantly raises
the rate of violence in people with schizophrenia, as is also the case
with people who do not have any mental illness. People with paranoid and
psychotic symptoms, which can become worse if medications are discontinued,
may also be at higher risk for violent behavior. For more information
on this issue - please see:

Daily
Schizophrenia Violence in the News - On any day you will find that
many of the news articles (if not most) that include reference to schizophrenia
relate to violence that is a result of schizophrenia. While only a small
percent of people with schizophrenia are violent, when violence takes
place (especially in the USA where the media focuses more heavily on
crime and violence compared to other countries) any violence related
to schizophrenia tends to be covered widely in the news media. Moreover,
violence and fatalities in association with schizophrenia are much more
common in the US due to the greater availability of hand guns and the
greater difficulty of getting good treatment and services for people
who have schizophrenia.

If you have a family member that has schizophrenia, is not taking medication
and has a history of violence, we recommend you review the information
on Assisted Treatment.

For more information on the preventable violence that is sometimes associated
with untreated schizophrenia (and how people are working towards changing
laws so that it can be avoided) please see the following web site: Treatment
Advocacy Center

In Out of the Shadows, published by John Wiley & Sons earlier this
year, I estimated that there are now approximately 1000 homicides a
year committed by individuals with schizophrenia and bipolar disorder,
almost all of whom were not taking medication at the time of the homicide.
My estimate was based on all cases in a metropolitan area of 4 million
people for 1 year, then extrapolated to the whole country. Anecdotal
evidence suggests that such cases are not unique to urban areas so I
think such extrapolation is reasonable. To date, nobody has challenged
this 1000/year estimate. Altogether in the US there are approximately
24,000 homicides a year.

Dr. E. Fuller Torrey

Note: I reviewed this in Surviving Schizphrenia (3rd ed., 1995), pp.
271-273. Since this was published, there have been at least three pertinent
papers:

The vast majority of people with schizophrenia who are in jail have been
charged with misdemeanors such as trespassing.

As many as one in five (20%) of the 2.1 million Americans in jail and
prison are seriously mentally ill, far outnumbering the number of mentally
ill who are in mental hospitals, according to a comprehensive study. Source:
Human
Rights Watch

The American Psychiatric Association estimated in 2000 that one in five
prisoners were seriously mentally ill, with up to 5 percent actively psychotic
at any given moment.

In 1999, the statistical arm of the Justice Department estimated that
16 percent of state and federal prisoners and inmates in jails were suffering
from mental illness. These illnesses included schizophrenia, manic depression
(or bipolar disorder) and major depression.

The figures are higher for female inmates, the report says. The Justice
Department study found that 29 percent of white female inmates, 22 percent
of Hispanic female inmates and 20 percent of black female inmates were
identified as mentally ill.

Many individuals with schizophrenia revolve between hospitals, jails
and shelters. In Illinois 30% of patients discharged from state psychiatric
hospitals are rehospitalized within 30 days. In New York 60% of discharged
patients are rehospitalized within a year. Source: Surviving
Schizophrenia

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